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目的探讨心脏X综合征的诊断与治疗方法。方法对28例心脏X综合征患者临床资料进行回顾性分析。结果心电图检查显示19例正常,24h动态心电图均监测到一过性缺血性ST段压低,平板运动试验阳性率100%,冠状动脉造影证实患者左、右冠状动脉及其分支未见明显狭窄;应用硝酸酯类药物、钙离子通道阻滞剂、β受体阻滞剂和/或盐酸曲美他嗪治疗有效;随访6个月～1.5a,患者均未出现心血管事件。结论心脏X综合征确诊需结合临床表现、平板运动试验结果等进行判断,必要时行冠状动脉造影术;其治疗以缓解心绞痛症状、改善生活质量和提高疾病预后为目的。
Objective To investigate the diagnosis and treatment of cardiac X syndrome. Methods The clinical data of 28 patients with cardiac X syndrome were retrospectively analyzed. Results Electrocardiogram showed that transient ischemic ST segment depression was detected in 19 normal and 24 h ambulatory electrocardiogram. The positive rate of treadmill exercise test was 100%. Coronary artery angiography showed no obvious stenosis in the left and right coronary arteries and their branches. The use of nitrates, calcium channel blockers, β-blockers and / or trimetazidine hydrochloride treatment is effective; follow-up 6 months to 1.5a, no cardiovascular events in patients. Conclusion The diagnosis of cardiac syndrome X need to be combined with clinical manifestations, treadmill exercise test results to determine, if necessary, coronary angiography; its treatment to relieve angina pectoris, improve quality of life and improve prognosis for the purpose.